Nicole Kloosterman, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

LL88154 Issued in SC

Practice address

135 Rutledge Ave # Msc550
Charleston, SC 29425-8903

Phone

(843) 792-8299

NPI assigned

Jun 14, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1023748019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 RUTLEDGE AVE # MSC550",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258903",
            "telephone_number": "843-792-8299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 RUTLEDGE AVE # MSC550",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258903",
            "telephone_number": "843-792-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOOSTERMAN",
        "first_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "LL88154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey John Kline, MD
• Alexis Klink, DO
• Eric Charles Klipsch, MD
• Michael Klodnicki, M.D.
• Andrew Joseph Kloehn, MD
• Christine Willis Kloot
• Mary Elizabeth Klopp, DO
• Ashley B Klumb, NNP
• KLW Counseling & Consulting, LLC
• Kathleen Knaak

• Otolaryngology Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Otolaryngology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.